1487831814 NPI number — COUNSELING CONNECTION, LLC

Table of content: DR. SHARON KAY DODD KIMMEY M.D. (NPI 1821213364)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487831814 NPI number — COUNSELING CONNECTION, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNSELING CONNECTION, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487831814
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 WESTBURY CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROBBINSVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08691-3646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-306-6709
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 DENOW RD STE V
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENNINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08534-5247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-306-6709
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GOLDSTEIN
Authorized Official First Name:
SHERRI
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
609-306-6709

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  44SC01024000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)